Cementless One-Stage Revision in Chronic Periprosthetic Hip Joint Infection. Ninety-One Percent Infection Free Survival in 56 Patients at Minimum 2-Year Follow-Up

Jeppe Lange, Anders Troelsen, Søren Solgaard, Kristian S Otte, Niels K Jensen, Kjeld Søballe, CORIHA Research Group

16 Citations (Scopus)

Abstract

BACKGROUND: Cementless 1-stage revision in chronic periprosthetic hip joint infections is limited evaluated. The purpose of this study was to evaluate a specific treatment protocol in this patient group.

METHODS: The study was performed as a multicenter, proof-of-concept, observational study with prospective data collection. Patients were treated with a cementless 1-stage revision according to the CORIHA protocol between 2009 and 2014. Fifty-six patients, McPherson type III-A/B-1/2, were enrolled with a mean follow-up time from the CORIHA procedure of 4 years (minimum of 2 years). The primary outcome was re-revision performed due to infection and was evaluated by competing risk analysis, with death and aseptic revision as competing events. All-cause mortality was evaluated by Kaplan-Meier survival analysis. Oxford Hip Score (OHS) was used as disease-specific patient-reported outcome measure.

RESULTS: The cumulative incidence of re-revision due to infection was 8.9% (confidence interval [CI] 3.2%-18.1%). The 1-year and 5-year survival incidence was 96% (CI 86%-99%) and 89% (CI 75%-95%). OHS at baseline was 19.9 (CI 17.3-22.6) and at 24-month follow-up 35.1 (CI 31.7-38.5). The mean change in OHS from baseline to 24-month follow-up was 11.8 points (CI 7.3; 16.3). Three patients had aseptic revision performed: two suffered periprosthetic fractures and one had stem subsidence. Failure analysis of the 5 reinfections did not detect a clear pattern as to the cause of failure.

CONCLUSION: We found that cementless 1-stage revision in chronic periprosthetic hip joint infections has low reinfection rates in selected patients and may be applicable as a first-line treatment.

Original languageEnglish
JournalJournal of Arthroplasty
Volume33
Issue number4
Pages (from-to)1160-1165.e1
ISSN0883-5403
DOIs
Publication statusPublished - 1 Apr 2018

Keywords

  • Adult
  • Aged
  • Arthroplasty, Replacement, Hip/adverse effects
  • Bone Cements
  • Cementation
  • Chronic Disease
  • Clinical Protocols
  • Female
  • Follow-Up Studies
  • Hip Joint/microbiology
  • Hip Prosthesis/adverse effects
  • Humans
  • Middle Aged
  • Prosthesis Failure
  • Prosthesis-Related Infections/drug therapy
  • Reoperation

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